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What are the sources of volatile acids in the body?
Volatile acids CO2, is formed during aerobic metabolism.
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What are the sources of non-volatile acids in the body?
Non-volatile acids are formed as end products of the metabolism of proteins, carbohydrates, and fats.
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How are volatile acids eliminated from the body?
Volatile acids are eliminated by the lungs.
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How are non-volatile acids eliminated from the body?
Non-voliate acids are mainly eliminated by kidneys by way of the urine. It can also be eliminated by way of the GI tract, for example due to vomiting of gastric fluids.
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Describe the limitations in regard to renal buffering in case of acid-base imbalance.
The kidneys take days to reach their maximum buffering capacity, and only if they are not the cause of the imbalance, or they are not contributing to the maintenance of the imbalance.
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Describe the limitations in regard to respiratory buffering in cases of acid-base imbalance.
Although the lungs start to compensate within minutes of acid-base imbalance, it can take several hours to reach maximum buffering capacity. Sometimes the lungs are not capable to return the pH all the way back within the normal range, only near the normal range.
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Explain why venous blood might be used in some situations instead of or in addition to arterial blood to assess acid-base status.
An individual with circulatory failure, or during cardio pulmonary arrest, when the value in the arterial blood can be affected by medications given in the blood, or due to the effects of mechanical ventilation.
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Explain why hypokalemia can lead to metabolic alkalosis.
In hypokalemia, the kidneys retain more potassiums and excrete more hydrogen ions, which results in alkalosis.
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Explain why hyperkalemia can lead to metabolic acidosis.
In hyperkalemia, the kidneys retain more hydrogen ions and excretes more potassiums, which results in acidosis.
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Why does the serum potassium level increase in acidosis?
In acidosis, the body protects itself from the acidic state by moving hydrogen ions into the cells. Therefore, potassium moves out to make room for hydrogen ions and the serum potassium level increases.
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Why does the serum potassium level decrease in alkalosis?
In alkalosis, the cells release hydrogen ions into the blood in an attempt to increase the acidity of the blood; this forces the serum potassium into the cell and potassium levels decrease.
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What is the difference between compensation for and correction of an acid-base imbalance?
Compensation is when the body doesn't correct the underlining disease; correction is when the underlining disease is treated.
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Explain why the base excess (BE) value is increased during metabolic alkalosis and decreased during metabolic acidosis.
BE is elevated when there's an increase level of base, such as bicarbonate in the blood, as in metabolic alkalosis. In metabolic acidosis, there's a decrease level of base, hence the BE value decreases.
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Why is the BE value increased during compensated respiratory acidosis and decreased during compensated respiratory alkalosis?
There will be a base deficit in state of partially or fully compensated respiratory alkalosis. This is because of the increase renal excretion of bicarbonate (HCO3-) that occurs as compensation for respiratory alkalosis.
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How does the anion gap help in the differential diagnosis of acid-base imbalances?
In state of lactic acidosis when lactic acid dissociate releasing its hydrogen ion, the anion lactate, which has a negative charge, is left behind.
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Explain the factors involved in the generation of metabolic alkalosis when there's loss of gastric fluid due to vomiting.
Metabolic alkalosis is generated due to factors that increase bicarbonate level in intracellular fluid, which happens when there's a loss of hydrochloride acid from vomiting or gastric suctioning.
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Explains the factors involved in the maintenance of metabolic alkalosis when there's loss of gastric fluid due to vomiting.
When there's a chloride deficiency (due to loss of hydrochloride acid in vomiting or gastric suctioning), bicarbonate will be reabsorb along with sodium because it is most abundant. Therefore, more bicarbonate is reabsorb into the urine, added to the blood, and this helps maintain the state of metabolic alkalosis.
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